Gait changes in children with spastic diplegia after selective dorsal rhizotomy

Area of Science:

• Neurology
• Orthopedic Surgery
• Pediatric Rehabilitation

Background:

• Spastic diplegia is a form of cerebral palsy characterized by increased muscle tone and stiffness in the lower extremities.
• Limited range of motion and impaired gait significantly affect the functional mobility and quality of life in affected children.

Purpose of the Study:

• To evaluate the effectiveness of selective dorsal rhizotomy in improving spasticity, range of motion, and gait parameters in ambulatory children with spastic diplegia.
• To analyze the impact of the procedure on both independent and dependent ambulators separately.

Main Methods:

• A cohort of 26 ambulatory children with spastic diplegia underwent preoperative and 1-year postoperative assessments.
• Evaluations included spasticity, passive range of motion, tone, 3D motion analysis, and electromyography.
• Data were analyzed separately for independent and dependent ambulators.

Main Results:

• A significant decrease in lower extremity spasticity was observed in all participants.
• Passive range of motion increased at the hip for both independent and dependent ambulators.
• Independent ambulators showed increased gait velocity and stride length. Dependent ambulators demonstrated improved hip extension, while both groups exhibited better knee extension and dorsiflexion during stance.

Conclusions:

• Selective dorsal rhizotomy is an effective intervention for reducing spasticity in children with spastic diplegia.
• The procedure leads to improvements in both passive and dynamic range of motion, positively impacting gait parameters and functional mobility.